tion folIowed by sudden cIosure of the gIottis, which resuhs from many causes or may occur without known cause. It occurs rarely in epidemic form. It is generaIIy reffex in nature, usuaIIy being initiated by some abnorma1 stimulation of the afferent nerve termina1 in the diaphragm. Hiccup may be due to stimulation of the respiratory center itseIf by some agent in the bIood or it may foIIow efferent nerve irritation as seen in aIcohoIic intoxication, toxic encephaIitis or serum sickness. Some authors state that the motor impuIse in the usua1 hiccup traveIs over the phrenic nerve. However, this is not entirely true as hiccup is seen occasionaIIy folIowing biIatera1 division of the phrenic nerve. CIonic contraction of the accessory muscIes of respiration, the intercosta1 and abdomina1, assist in producing hiccup and probably produce the hiccup in those cases foIIowing biIatera1 phrenectomy. This is especiaIIy true in cases of centra1 nervous system origin. Persistent hiccup often threatens Iife by exhaustion, particuIarIy when it complicates surgery. The great majority of cases occur in men; and while the age incidence varies considerably, the majority of cases are found to be males over fifty years of age, the average age being fifty-four and a haIf. There seems to be a definite period of the year, in ApriI and September,l when this condition is seen most frequentIy. The onset of the compIication varies but it generaIIy occurs between the first to the seventh postoperative days. Most postoperative cases seem to foIIow operations within the peritonea1 cavity. However, hiccup is reported frequentIy as a compIication in such procedures as prostatectomy, catheterization, cystoscopy foIIowing proIonged indweIIing catheters and a rare case is reported foIIowing prostatic massage. The maIady does, moreover, complicate any surgica1 or genera1 medica disease. The literature on the treatment of hiccup is voIuminous and the Iate CharIes W. Mayo stated that no disease has had more _. forms of treatment and fewer therapeutic resuIts than has persistent hiccup. Dean Lewis states that practicaIIy every drug in the Pharmacopoeia has been advocated to combat hiccup. InnumerabIe forms of treatment have been suggested by the various authors, the most commonIy recommended being sedation by barbituates, inhaIation of carbon dioxide 5 to IO per cent with oxygen, pressure over the vagus nerve, gastric Iavage, proIonged traction on the tongue, painting of the nasa1 pharynx with iodine or other strong irritants, the swallowing of gastric irritants, pressure on the eyebaIls, chIoroform by mouth, administration of antispasmodics incIuding benzedrine hypodermically, infiItration of the phrenic nerve with novocain and, if these measures fai1, phrenectomy. Rosenowl reported a spasm-producing type of streptococci obtained from the nasopharynx, from miIk suppIies and from outdoor air during epidemic prevaIence of hiccup. He prepared a serum which may be given with benefit in persistent hiccup, both epidemic and postoperative. His concIusion is that persistent hiccup shouId be considered as a form of miId myocIonic encephaIitis. He obtained a significant reduction in the spasms folIowing intramuscuIar injection of his especiaIIy prepared vaccine. With the exception of Rosenow’s paper, most of the Literature comes to the con-